California DWC

CA DWC: Continued Failure of Regulatory Oversight
Dec 5, 2023
CA DWC: Continued Failure of Regulatory Oversight
California has laws and regulations requiring claims administrators to timely and compliantly conduct Utilization Review (UR) of every treatment recommended by an injured wor...
Attn CA DWC: Where Is the UR Reporting System?
Dec 4, 2023
Attn CA DWC: Where Is the UR Reporting System?
In 2014, California legislators enacted laws requiring employers to conduct Utilization Review (UR) for every treatment recommended for a work-related injury. I...
DWC's New MPN List Helps No One
Oct 30, 2023
DWC's New MPN List Helps No One
California’s Medical Provider Network (MPN) system is an unmitigated disaster — and the latest “solution” from the Division of Workers’ Compensation (DWC) is laughable in its...
Why Does CA DWC 1 Form Fail to Mention Mandated MAAs?
Oct 26, 2023
Why Does CA DWC 1 Form Fail to Mention Mandated MAAs?
The DWC 1 form, created by California’s Division of Workers’ Compensation (DWC) to satisfy its legal mandate to inform newly injured workers of their rights and benefits, fai...
DWC 1 Does Not Help Injured Workers Navigate MPNs
Oct 23, 2023
DWC 1 Does Not Help Injured Workers Navigate MPNs
As California considers desperately needed reforms of the Medical Provider Network (MPN) system, one reform is arguably more necessary and easily achievable than most: fully ...
CA DWC 1 Form Throws Wounded Workers to Wolves
Oct 19, 2023
CA DWC 1 Form Throws Wounded Workers to Wolves
California law requires the Division of Workers’ Compensation (DWC) to provide clear and concise explanations of workers’ comp benefits to injured workers. This is a sensible...
CA DWC Fails to Support Injured Workers' Rights Under MPNs
Oct 17, 2023
CA DWC Fails to Support Injured Workers' Rights Under MPNs
When a California employee sustains a work-related injury, and the employer maintains a Medical Provider Network (MPN), it is the employer’s legal responsibility to (within o...
Obituary: Major CA Practice Quits Workers' Comp Treatment
Oct 4, 2023
Obituary: Major CA Practice Quits Workers' Comp Treatment
RIP RehabOne Medical Group, 2004-2023California workers’ comp will lose a pillar of the provider community, effective at the close of this year. RehabOne will have pro...
SCIF Inept UR #6: Non-MTUS Guidelines Strike Again
Sep 29, 2023
SCIF Inept UR #6: Non-MTUS Guidelines Strike Again
Once again, State Compensation Insurance Fund (SCIF) and EK Health denied surgery for an injured worker by citing unadopted, alternative treatment guidelines outside of Calif...
FYI: Inaccurate DWC IBR Form May Cost Your Practice
Sep 14, 2023
FYI: Inaccurate DWC IBR Form May Cost Your Practice
California’s Division of Workers’ Compensation (DWC) has strict and specific requirements for providers who wish to dispute incorrect payment amounts through Independent Bill...
Tristar: 2,315 Audit Complaints Filed With CA DWC
Sep 5, 2023
Tristar: 2,315 Audit Complaints Filed With CA DWC
Third-Party Administrator (TPA) Tristar Risk Management continues to ignore California workers’ comp billing regulations with impunity, burdening providers with administrativ...
Audit Complaints: Zurich Rejecting Valid e-Bills
Jul 31, 2023
Audit Complaints: Zurich Rejecting Valid e-Bills
Zurich Insurance North America is failing to reimburse providers for treating injured workers.Since early June, Zurich has incorrectly rejected 745 valid e-bills submi...